Lifestyle plays an important role in the development of obesity during childhood and adolescence. We provide up-to-date information about the relationship between obesity and food intake and dietary patterns in adolescents. Scientific evidence is increasing about the dietary factors associated with this relationship, specifically a low meal frequency, skipping breakfast, and a high consumption of sugar sweetened beverages. Maybe some of the reviewed dietary factors could cluster in the same population of adolescents, increasing the individual risk. There is little information about dietary patterns and current time trends in adolescents; however, the available data seem to show that the tendency in the adolescent population worldwide is to increase those dietary factors related with obesity development. Public health efforts should be emphasized in order to decrease the current tendency. Regular family meals could serve as role models for healthy eating behaviors. Educational intervention programs for parents, aiming to modify the healthfulness of the diet, seems to be one of the most adequate tools to deal with the worldwide obesity epidemic.

Adolescents with anorexia nervosa have significant functional and structural cardiac abnormalities; weight gain was associated with improvement. Appropriate attention should be paid to cardiac involvement.

Objective: To obtain reference values of the waist circumference in Spanish children, and to investigate their dependence on age and gender. Design: Cross-sectional study. Setting: General school-age population. Subjects: A representative sample of the schools in Zaragoza, Spain, was drawn from seven schools. The population selected comprised 1728 children with ages ranging from 6.0±14.9 y. Of the original sample, 368 children (21.29%) were excluded because of chronic diseases or refusal. Finally, 1360 children and adolescents: 701 boys and 659 girls, were studied. Interventions: Waist and hip circumferences were measured with an unelastic tape. Results: Waist circumference tended to be higher in males than in females and this difference was signi®cant after 11.5 y. In general, hip circumference was higher in females than in males (statistically signi®cant differences at 7.5, 10.5, 12.5 and 13.5 y). In general, percentile values of waist circumference were higher in males than in females, especially after 12.5 y. Difference between males and females on percentile 95 at 14.5 y was 7.6 cm. Hip was greater than waist in both sexes, and the two curves run nearly parallel in males. In females, while hip enlarges continuously, waist shows the reverse tendency between 11.5 and 14.5 y. Conclusions: Waist circumference showed higher values in boys than in girls, especially after 11.5 y, and waist values increase with age both in males and females. These ®ndings justify the use of age and gender speci®c reference standards. Sponsorship: This work was supported by grant 216-02 from Universidad de Zaragoza, Zaragoza, Spain.

Objective: To describe the prevalence of overweight and obesity in the Spanish adolescent population and its relationship with the socioeconomic status, and to assess their body fat composition and compare these results with previous data from our own country. Design: Cross-sectional multicenter study conducted in five Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) in 2000–2002. Subjects: 2,320 adolescents with complete set of anthropometric measurements, 1,192 boys and 1,128 girls. Measurements: Body mass index calculated from weight and height measurements, and body fat percentage calculated from skinfold thickness measurements. Results: Overweight + obesity prevalences were 25.69 and 19.13% in boys and girls, respectively. Overweight + obesity prevalence increased in boys from high to medium-low socioeconomic status categories (p = 0.015); meanwhile, there was not a significant effect of socioeconomic status in girls. In males, overweight + obesity prevalence changed from 1985 to 2000–2002 from 13 to 35% and in females from 16 to 32%. The rate of change in overweight + obesity prevalences seems to increase in the last years; from 0.88 (1985 to 1995) to 2.33%/year (1995 to 2000–2002) in males and from 0.5 (1985 to 1995) to 1.83%/year (1995 to 2000–2002) in females. The rate of body fat percentage increase was similar between 1980 and 1995 and between 1995 and 2000–2002: 0.26 and 0.23%/year, respectively, at 13 years of age, and 0.16 and 0.17%/year, respectively, at 14 years of age. Conclusion: We observed elevated overweight and obesity prevalences in Spanish adolescents, similar to those observed in other European countries. There is a significant inverse relationship between socioeconomic status and overweight + obesity, but only in boys. The rate of change in overweight prevalence in Spanish adolescents seems to increase, and the rate of increase of body fat percentage seems to be similar as in previous years.